Monday, August 4, 2008

Neuro Week

This is neuro week! An emaciated homeless man with alcohol on his breath presents to your emergency department confused and unable to walk. On examination, you find profound disorientation and lack of attention. Neuro exam shows horizontal nystagmus, bilateral cranial nerve VI palsy, and sluggish pupils. Unfortunately, he does not survive and an autopsy is done, showing this:

Challenge: What is the importance of the following molecule?
Related Question:
1. What does the pathology specimen show? Where is the lesion?
2. What is the diagnosis? What is the clinical triad here?

First image shown under fair use, second image in the public domain.

1 comment:

Craig said...

Neuro Week

This is the presentation of Wernicke-Korsakoff syndrome with the classic triad of encephalopathy, oculomotor dysfunction, and gait ataxia in a chronic alcoholic. The pathology shows hemorrhaging in the mamillary bodies which is characteristic of this disease (acute Wernicke encephalopathy lesions also include vascular congestion, microglial proliferation, and petechial hemorrhages). The molecule thiamine is shown because it is a safe, simple, inexpensive, and effective treatment for this disease. Thiamine should be given before glucose to prevent worsening of the disease.

Sources: UpToDate;; Wikipedia.